Dysphagia and Factors Associated with Respiratory Infections in the First Week Post Stroke
Dysphagia and Factors Associated with Respiratory Infections in the First Week Post Stroke
复制标题
DOI：
10.1159/000366423
复制
发表时间：
2014-01-01
影响因子：
5.7
通讯作者：
Blacker, David
中科院分区：
文献类型：
--
作者：
Brogan, Emily;Langdon, Claire;Blacker, David
背景资料：吞咽困难发生在大约一半的中风患者中，并与呼吸道感染有关;然而，尚不清楚其他哪些因素导致风险增加。本研究旨在提供中风极急性期呼吸道感染相关因素的证据。方法：回顾性分析2010年澳大利亚医院收治的536例脑卒中患者。收集了37个临床和人口统计学参数的数据。进行单变量和多变量logistic回归分析。结果：呼吸道感染总发生率为11%。入院时，需要完全协助活动[OR 6.48，95% CI 1.35，31.161]和尿失禁[OR 3.21，95% CI 1.16，8.87]与呼吸道感染相关。在卒中后第一周，鼻胃管（NGT）[OR 3.91，95% CI 1.73，8.80]和经口无菌（NBM）[OR 5.62，95% CI 1.54，20.46]与呼吸道感染相关。GCS受损、缺血性卒中和活动能力显著受损与吞咽困难相关。结论：这项对急性卒中患者的大型队列研究支持吸入性肺炎本质上是多因素的研究。NGT与呼吸道感染风险增加相关，并可能通过促进口咽定植而导致感染。活动能力严重受损的患者也有很高的呼吸道感染风险。(C)2014 S. Karger AG，巴塞尔。
Background: Dysphagia occurs in approximately half of the stroke patients and is associated with respiratory infections; however, it is unclear what other factors contribute to an increased risk. This study aimed to provide evidence on factors associated with respiratory infections in the very acute stroke period. Methods: Retrospective review of 536 stroke patients admitted to Australian Hospitals in 2010. Data were collected on 37 clinical and demographic parameters. Univariable and multivariable logistic regression was performed. Results: The overall incidence of respiratory infection was 11%. On admission, requiring full assistance with mobility [OR 6.48, 95% CI 1.35, 31.161 and urinary incontinence [OR 3.21, 95% CI 1.16, 8.87] were associated with respiratory infections. During the first week post stroke nasogastric tubes (NGT) [OR 3.91, 95% Cl 1.73, 8.80] and Nil By Mouth (NBM) [OR 5.62, 95% CI 1.54, 20.46] were associated with respiratory infections. Impaired GCS, ischaemic stroke and significantly impaired mobility were associated with swallowing difficulties. Conclusion: This study of a large cohort of acute stroke patients supports research indicating aspiration pneumonia is multifactorial in nature. NGT were associated with increased risk of respiratory infections and may contribute to infections by promoting oropharyngeal colonisation. Patients with severely impaired mobility were also at very high risk of respiratory infection. (C) 2014 S. Karger AG, Basel.